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Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part D Diagnosis
Chapter 16. Diagnostic Tests
Toshi A. Furukawa, Sharon Strauss, Heiner C. Bucher, Gordon Guyatt
The story of carcinoembryonic antigen (CEA) testing in patients with colorectal cancer shows how...


Topics Discussed: bias, epidemiologic, colorectal cancer, criterion standard comparisons (diagnostic tests), dementia, diagnostic process, diagnostic studies, diagnostic techniques and procedures, higher cerebral function, assessment and interpretation, interpretation of results, mental status determination, reference standards, validity of evidence, verification bias

Excerpt: "Table 16-1 summarizes our Users' Guides for assessing the validity, examining the results, and determining the applicability of a study reporting on the accuracy of a diagnostic test.A diagnostic test is useful only if it distinguishes between conditions and disorders that might otherwise be confusing. Although most tests can differentiate healthy persons from severely affected ones, this ability will not help us in clinical practice. Studies that confine themselves to florid cases vs asymptomatic healthy volunteers are unhelpful because, when the diagnosis is obvious, we do not need a diagnostic test. Only a study that closely resembles clinical practice and includes patients with mild, early manifestations of the target condition can establish a test's true value...."
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